|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM
|
Facility
|
OP
|
$526.00
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
12042
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$447.10
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cofinity Commercial |
$368.20
|
| Rate for Payer: Cofinity Commercial |
$452.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$368.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$473.40
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.10
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$447.10
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.90
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$331.38
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
HCPCS 12042
|
| Hospital Charge Code |
12042
|
| Min. Negotiated Rate |
$184.98 |
| Max. Negotiated Rate |
$342.21 |
| Rate for Payer: Aetna Commercial |
$247.87
|
| Rate for Payer: Aetna Medicare |
$192.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.37
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: BCBS MAPPO |
$184.98
|
| Rate for Payer: BCN Medicare Advantage |
$184.98
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Cofinity Commercial |
$266.37
|
| Rate for Payer: Cofinity Commercial |
$247.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.98
|
| Rate for Payer: Healthscope Commercial |
$295.97
|
| Rate for Payer: Healthscope Commercial |
$342.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$341.90
|
| Rate for Payer: Nomi Health Commercial |
$221.98
|
| Rate for Payer: PACE SWMI |
$184.98
|
| Rate for Payer: PHP Medicare Advantage |
$184.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.90
|
| Rate for Payer: Priority Health Medicare |
$184.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.98
|
| Rate for Payer: UHC Medicare Advantage |
$184.98
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM
|
Professional
|
Both
|
$1,145.00
|
|
|
Service Code
|
HCPCS 12047
|
| Min. Negotiated Rate |
$339.64 |
| Max. Negotiated Rate |
$744.25 |
| Rate for Payer: Aetna Commercial |
$455.12
|
| Rate for Payer: Aetna Medicare |
$353.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$489.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.12
|
| Rate for Payer: BCBS Complete |
$458.00
|
| Rate for Payer: BCBS MAPPO |
$339.64
|
| Rate for Payer: BCN Medicare Advantage |
$339.64
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cash Price |
$916.00
|
| Rate for Payer: Cofinity Commercial |
$489.08
|
| Rate for Payer: Cofinity Commercial |
$455.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.64
|
| Rate for Payer: Healthscope Commercial |
$543.42
|
| Rate for Payer: Healthscope Commercial |
$628.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$356.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$744.25
|
| Rate for Payer: Nomi Health Commercial |
$407.57
|
| Rate for Payer: PACE SWMI |
$339.64
|
| Rate for Payer: PHP Medicare Advantage |
$339.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$744.25
|
| Rate for Payer: Priority Health Medicare |
$339.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.64
|
| Rate for Payer: UHC Medicare Advantage |
$339.64
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 12044
|
| Hospital Charge Code |
12044
|
| Min. Negotiated Rate |
$204.50 |
| Max. Negotiated Rate |
$378.32 |
| Rate for Payer: Aetna Commercial |
$274.03
|
| Rate for Payer: Aetna Medicare |
$212.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.48
|
| Rate for Payer: BCBS Complete |
$226.00
|
| Rate for Payer: BCBS MAPPO |
$204.50
|
| Rate for Payer: BCN Medicare Advantage |
$204.50
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$294.48
|
| Rate for Payer: Cofinity Commercial |
$274.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.50
|
| Rate for Payer: Healthscope Commercial |
$327.20
|
| Rate for Payer: Healthscope Commercial |
$378.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.25
|
| Rate for Payer: Nomi Health Commercial |
$245.40
|
| Rate for Payer: PACE SWMI |
$204.50
|
| Rate for Payer: PHP Medicare Advantage |
$204.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health Medicare |
$204.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.50
|
| Rate for Payer: UHC Medicare Advantage |
$204.50
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Professional
|
Both
|
$565.00
|
|
|
Service Code
|
HCPCS 12044
|
| Min. Negotiated Rate |
$204.50 |
| Max. Negotiated Rate |
$378.32 |
| Rate for Payer: Aetna Commercial |
$274.03
|
| Rate for Payer: Aetna Medicare |
$212.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$294.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.03
|
| Rate for Payer: BCBS Complete |
$226.00
|
| Rate for Payer: BCBS MAPPO |
$204.50
|
| Rate for Payer: BCN Medicare Advantage |
$204.50
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$294.48
|
| Rate for Payer: Cofinity Commercial |
$274.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.50
|
| Rate for Payer: Healthscope Commercial |
$378.32
|
| Rate for Payer: Healthscope Commercial |
$327.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.25
|
| Rate for Payer: Nomi Health Commercial |
$245.40
|
| Rate for Payer: PACE SWMI |
$204.50
|
| Rate for Payer: PHP Medicare Advantage |
$204.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health Medicare |
$204.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.50
|
| Rate for Payer: UHC Medicare Advantage |
$204.50
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Facility
|
OP
|
$565.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
12044
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$319.99 |
| Max. Negotiated Rate |
$1,680.50 |
| Rate for Payer: Aetna Commercial |
$480.25
|
| Rate for Payer: Aetna Medicare |
$620.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$746.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$746.25
|
| Rate for Payer: BCBS Complete |
$335.99
|
| Rate for Payer: BCBS MAPPO |
$597.00
|
| Rate for Payer: BCN Medicare Advantage |
$597.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$395.50
|
| Rate for Payer: Cofinity Commercial |
$485.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$395.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$597.00
|
| Rate for Payer: Healthscope Commercial |
$508.50
|
| Rate for Payer: Mclaren Medicaid |
$319.99
|
| Rate for Payer: Mclaren Medicare |
$597.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$626.85
|
| Rate for Payer: Meridian Medicaid |
$335.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.25
|
| Rate for Payer: PACE Medicare |
$567.15
|
| Rate for Payer: PACE SWMI |
$597.00
|
| Rate for Payer: PHP Commercial |
$480.25
|
| Rate for Payer: PHP Medicare Advantage |
$597.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health Medicare |
$597.00
|
| Rate for Payer: Priority Health SBD |
$355.95
|
| Rate for Payer: Railroad Medicare Medicare |
$597.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,680.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$597.00
|
| Rate for Payer: UHC Medicare Advantage |
$597.00
|
| Rate for Payer: UHCCP Medicaid |
$336.11
|
| Rate for Payer: VA VA |
$597.00
|
|
|
PR REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM
|
Facility
|
IP
|
$565.00
|
|
|
Service Code
|
CPT 12044
|
| Hospital Charge Code |
12044
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$355.95 |
| Max. Negotiated Rate |
$508.50 |
| Rate for Payer: Aetna Commercial |
$480.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$367.25
|
| Rate for Payer: Cash Price |
$452.00
|
| Rate for Payer: Cofinity Commercial |
$395.50
|
| Rate for Payer: Cofinity Commercial |
$485.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$395.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$452.00
|
| Rate for Payer: Healthscope Commercial |
$508.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$480.25
|
| Rate for Payer: PHP Commercial |
$480.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.25
|
| Rate for Payer: Priority Health SBD |
$355.95
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 12035
|
| Min. Negotiated Rate |
$230.53 |
| Max. Negotiated Rate |
$451.10 |
| Rate for Payer: Aetna Commercial |
$308.91
|
| Rate for Payer: Aetna Medicare |
$239.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.91
|
| Rate for Payer: BCBS Complete |
$277.60
|
| Rate for Payer: BCBS MAPPO |
$230.53
|
| Rate for Payer: BCN Medicare Advantage |
$230.53
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$331.96
|
| Rate for Payer: Cofinity Commercial |
$308.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.53
|
| Rate for Payer: Healthscope Commercial |
$368.85
|
| Rate for Payer: Healthscope Commercial |
$426.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.10
|
| Rate for Payer: Nomi Health Commercial |
$276.64
|
| Rate for Payer: PACE SWMI |
$230.53
|
| Rate for Payer: PHP Medicare Advantage |
$230.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health Medicare |
$230.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.53
|
| Rate for Payer: UHC Medicare Advantage |
$230.53
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Facility
|
IP
|
$694.00
|
|
|
Service Code
|
CPT 12035
|
| Hospital Charge Code |
12035
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$437.22 |
| Max. Negotiated Rate |
$624.60 |
| Rate for Payer: Aetna Commercial |
$589.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.10
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$485.80
|
| Rate for Payer: Cofinity Commercial |
$596.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$485.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.20
|
| Rate for Payer: Healthscope Commercial |
$624.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.90
|
| Rate for Payer: PHP Commercial |
$589.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health SBD |
$437.22
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Professional
|
Both
|
$694.00
|
|
|
Service Code
|
HCPCS 12035
|
| Hospital Charge Code |
12035
|
| Min. Negotiated Rate |
$230.53 |
| Max. Negotiated Rate |
$451.10 |
| Rate for Payer: Aetna Commercial |
$308.91
|
| Rate for Payer: Aetna Medicare |
$239.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$331.96
|
| Rate for Payer: BCBS Complete |
$277.60
|
| Rate for Payer: BCBS MAPPO |
$230.53
|
| Rate for Payer: BCN Medicare Advantage |
$230.53
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$331.96
|
| Rate for Payer: Cofinity Commercial |
$308.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.53
|
| Rate for Payer: Healthscope Commercial |
$368.85
|
| Rate for Payer: Healthscope Commercial |
$426.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$451.10
|
| Rate for Payer: Nomi Health Commercial |
$276.64
|
| Rate for Payer: PACE SWMI |
$230.53
|
| Rate for Payer: PHP Medicare Advantage |
$230.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health Medicare |
$230.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.53
|
| Rate for Payer: UHC Medicare Advantage |
$230.53
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM
|
Facility
|
OP
|
$694.00
|
|
|
Service Code
|
CPT 12035
|
| Hospital Charge Code |
12035
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$589.90
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$451.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cash Price |
$555.20
|
| Rate for Payer: Cofinity Commercial |
$485.80
|
| Rate for Payer: Cofinity Commercial |
$596.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$485.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$555.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$624.60
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$589.90
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$589.90
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$451.10
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$437.22
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM
|
Professional
|
Both
|
$869.00
|
|
|
Service Code
|
HCPCS 12036
|
| Min. Negotiated Rate |
$271.12 |
| Max. Negotiated Rate |
$564.85 |
| Rate for Payer: Aetna Commercial |
$363.30
|
| Rate for Payer: Aetna Medicare |
$281.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$363.30
|
| Rate for Payer: BCBS Complete |
$347.60
|
| Rate for Payer: BCBS MAPPO |
$271.12
|
| Rate for Payer: BCN Medicare Advantage |
$271.12
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cash Price |
$695.20
|
| Rate for Payer: Cofinity Commercial |
$390.41
|
| Rate for Payer: Cofinity Commercial |
$363.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$271.12
|
| Rate for Payer: Healthscope Commercial |
$501.57
|
| Rate for Payer: Healthscope Commercial |
$433.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$284.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$564.85
|
| Rate for Payer: Nomi Health Commercial |
$325.34
|
| Rate for Payer: PACE SWMI |
$271.12
|
| Rate for Payer: PHP Medicare Advantage |
$271.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.85
|
| Rate for Payer: Priority Health Medicare |
$271.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$271.12
|
| Rate for Payer: UHC Medicare Advantage |
$271.12
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
12031
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$248.22 |
| Max. Negotiated Rate |
$354.60 |
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$275.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health SBD |
$248.22
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 12031
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$263.55 |
| Rate for Payer: Aetna Commercial |
$190.90
|
| Rate for Payer: Aetna Medicare |
$148.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.90
|
| Rate for Payer: BCBS Complete |
$157.60
|
| Rate for Payer: BCBS MAPPO |
$142.46
|
| Rate for Payer: BCN Medicare Advantage |
$142.46
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$205.14
|
| Rate for Payer: Cofinity Commercial |
$190.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.46
|
| Rate for Payer: Healthscope Commercial |
$227.94
|
| Rate for Payer: Healthscope Commercial |
$263.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.10
|
| Rate for Payer: Nomi Health Commercial |
$170.95
|
| Rate for Payer: PACE SWMI |
$142.46
|
| Rate for Payer: PHP Medicare Advantage |
$142.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$142.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.46
|
| Rate for Payer: UHC Medicare Advantage |
$142.46
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 12031
|
| Hospital Charge Code |
12031
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$334.90
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$275.80
|
| Rate for Payer: Cofinity Commercial |
$338.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$275.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$354.60
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.90
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$334.90
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$248.22
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<
|
Professional
|
Both
|
$394.00
|
|
|
Service Code
|
HCPCS 12031
|
| Hospital Charge Code |
12031
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$263.55 |
| Rate for Payer: Aetna Commercial |
$190.90
|
| Rate for Payer: Aetna Medicare |
$148.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.14
|
| Rate for Payer: BCBS Complete |
$157.60
|
| Rate for Payer: BCBS MAPPO |
$142.46
|
| Rate for Payer: BCN Medicare Advantage |
$142.46
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cash Price |
$315.20
|
| Rate for Payer: Cofinity Commercial |
$205.14
|
| Rate for Payer: Cofinity Commercial |
$190.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.46
|
| Rate for Payer: Healthscope Commercial |
$227.94
|
| Rate for Payer: Healthscope Commercial |
$263.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.10
|
| Rate for Payer: Nomi Health Commercial |
$170.95
|
| Rate for Payer: PACE SWMI |
$142.46
|
| Rate for Payer: PHP Medicare Advantage |
$142.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$256.10
|
| Rate for Payer: Priority Health Medicare |
$142.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.46
|
| Rate for Payer: UHC Medicare Advantage |
$142.46
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
HCPCS 12032
|
| Min. Negotiated Rate |
$179.15 |
| Max. Negotiated Rate |
$331.43 |
| Rate for Payer: Aetna Commercial |
$240.06
|
| Rate for Payer: Aetna Medicare |
$186.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.06
|
| Rate for Payer: BCBS Complete |
$201.20
|
| Rate for Payer: BCBS MAPPO |
$179.15
|
| Rate for Payer: BCN Medicare Advantage |
$179.15
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$257.98
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.15
|
| Rate for Payer: Healthscope Commercial |
$331.43
|
| Rate for Payer: Healthscope Commercial |
$286.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.95
|
| Rate for Payer: Nomi Health Commercial |
$214.98
|
| Rate for Payer: PACE SWMI |
$179.15
|
| Rate for Payer: PHP Medicare Advantage |
$179.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.95
|
| Rate for Payer: Priority Health Medicare |
$179.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.15
|
| Rate for Payer: UHC Medicare Advantage |
$179.15
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Professional
|
Both
|
$503.00
|
|
|
Service Code
|
HCPCS 12032
|
| Hospital Charge Code |
12032
|
| Min. Negotiated Rate |
$179.15 |
| Max. Negotiated Rate |
$331.43 |
| Rate for Payer: Aetna Commercial |
$240.06
|
| Rate for Payer: Aetna Medicare |
$186.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.98
|
| Rate for Payer: BCBS Complete |
$201.20
|
| Rate for Payer: BCBS MAPPO |
$179.15
|
| Rate for Payer: BCN Medicare Advantage |
$179.15
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$257.98
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.15
|
| Rate for Payer: Healthscope Commercial |
$286.64
|
| Rate for Payer: Healthscope Commercial |
$331.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.95
|
| Rate for Payer: Nomi Health Commercial |
$214.98
|
| Rate for Payer: PACE SWMI |
$179.15
|
| Rate for Payer: PHP Medicare Advantage |
$179.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.95
|
| Rate for Payer: Priority Health Medicare |
$179.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.15
|
| Rate for Payer: UHC Medicare Advantage |
$179.15
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Facility
|
OP
|
$503.00
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
12032
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$427.55
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$352.10
|
| Rate for Payer: Cofinity Commercial |
$432.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$352.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$452.70
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.55
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$427.55
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.95
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$316.89
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM
|
Facility
|
IP
|
$503.00
|
|
|
Service Code
|
CPT 12032
|
| Hospital Charge Code |
12032
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$316.89 |
| Max. Negotiated Rate |
$452.70 |
| Rate for Payer: Aetna Commercial |
$427.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$326.95
|
| Rate for Payer: Cash Price |
$402.40
|
| Rate for Payer: Cofinity Commercial |
$352.10
|
| Rate for Payer: Cofinity Commercial |
$432.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$352.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$402.40
|
| Rate for Payer: Healthscope Commercial |
$452.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$427.55
|
| Rate for Payer: PHP Commercial |
$427.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$326.95
|
| Rate for Payer: Priority Health SBD |
$316.89
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E >30.0 CM
|
Professional
|
Both
|
$758.00
|
|
|
Service Code
|
HCPCS 12037
|
| Min. Negotiated Rate |
$303.20 |
| Max. Negotiated Rate |
$582.08 |
| Rate for Payer: Aetna Commercial |
$421.62
|
| Rate for Payer: Aetna Medicare |
$327.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$453.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$421.62
|
| Rate for Payer: BCBS Complete |
$303.20
|
| Rate for Payer: BCBS MAPPO |
$314.64
|
| Rate for Payer: BCN Medicare Advantage |
$314.64
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cash Price |
$606.40
|
| Rate for Payer: Cofinity Commercial |
$453.08
|
| Rate for Payer: Cofinity Commercial |
$421.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$314.64
|
| Rate for Payer: Healthscope Commercial |
$503.42
|
| Rate for Payer: Healthscope Commercial |
$582.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$330.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$492.70
|
| Rate for Payer: Nomi Health Commercial |
$377.57
|
| Rate for Payer: PACE SWMI |
$314.64
|
| Rate for Payer: PHP Medicare Advantage |
$314.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.70
|
| Rate for Payer: Priority Health Medicare |
$314.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$314.64
|
| Rate for Payer: UHC Medicare Advantage |
$314.64
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
HCPCS 12034
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$416.65 |
| Rate for Payer: Aetna Commercial |
$260.31
|
| Rate for Payer: Aetna Medicare |
$202.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.31
|
| Rate for Payer: BCBS Complete |
$256.40
|
| Rate for Payer: BCBS MAPPO |
$194.26
|
| Rate for Payer: BCN Medicare Advantage |
$194.26
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$279.73
|
| Rate for Payer: Cofinity Commercial |
$260.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.26
|
| Rate for Payer: Healthscope Commercial |
$359.38
|
| Rate for Payer: Healthscope Commercial |
$310.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.65
|
| Rate for Payer: Nomi Health Commercial |
$233.11
|
| Rate for Payer: PACE SWMI |
$194.26
|
| Rate for Payer: PHP Medicare Advantage |
$194.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.65
|
| Rate for Payer: Priority Health Medicare |
$194.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.26
|
| Rate for Payer: UHC Medicare Advantage |
$194.26
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Facility
|
IP
|
$641.00
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
12034
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$403.83 |
| Max. Negotiated Rate |
$576.90 |
| Rate for Payer: Aetna Commercial |
$544.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.65
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$448.70
|
| Rate for Payer: Cofinity Commercial |
$551.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$448.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.80
|
| Rate for Payer: Healthscope Commercial |
$576.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.85
|
| Rate for Payer: PHP Commercial |
$544.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.65
|
| Rate for Payer: Priority Health SBD |
$403.83
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Facility
|
OP
|
$641.00
|
|
|
Service Code
|
CPT 12034
|
| Hospital Charge Code |
12034
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$208.85 |
| Max. Negotiated Rate |
$1,096.83 |
| Rate for Payer: Aetna Commercial |
$544.85
|
| Rate for Payer: Aetna Medicare |
$405.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$448.70
|
| Rate for Payer: Cofinity Commercial |
$551.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$448.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$576.90
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.85
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$544.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.65
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health SBD |
$403.83
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,096.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$219.37
|
| Rate for Payer: VA VA |
$389.65
|
|
|
PR REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM
|
Professional
|
Both
|
$641.00
|
|
|
Service Code
|
HCPCS 12034
|
| Hospital Charge Code |
12034
|
| Min. Negotiated Rate |
$194.26 |
| Max. Negotiated Rate |
$416.65 |
| Rate for Payer: Aetna Commercial |
$260.31
|
| Rate for Payer: Aetna Medicare |
$202.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.73
|
| Rate for Payer: BCBS Complete |
$256.40
|
| Rate for Payer: BCBS MAPPO |
$194.26
|
| Rate for Payer: BCN Medicare Advantage |
$194.26
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cash Price |
$512.80
|
| Rate for Payer: Cofinity Commercial |
$279.73
|
| Rate for Payer: Cofinity Commercial |
$260.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.26
|
| Rate for Payer: Healthscope Commercial |
$310.82
|
| Rate for Payer: Healthscope Commercial |
$359.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.65
|
| Rate for Payer: Nomi Health Commercial |
$233.11
|
| Rate for Payer: PACE SWMI |
$194.26
|
| Rate for Payer: PHP Medicare Advantage |
$194.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$416.65
|
| Rate for Payer: Priority Health Medicare |
$194.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.26
|
| Rate for Payer: UHC Medicare Advantage |
$194.26
|
|
